My view ...

The private blog of Andy Prevost. My experiences, my words. On any topic ...

It's frustrating ... seborrhea

I do quite a bit of research. It's been a mission to resolve some of my health issues. In all of this research, I have focused primarily on medical and scientific data. I tend to ignore the outer fringes – those that claims "cures" or try to sell ebooks and other information.

Most of my health issues are due to a barely functional pancreas. With only 1% to 2% functionality remaining, I am diabetic and insulin dependent. My pancreas also does not product any digestive enzymes, so meals and snacks require prescription enzymes. Despite these enzymes, I am plagued by poor absorption of nutrients from the food I eat (mal-absorption) and mal-nutrition. This causes another condition called "steatorrhea". Other malnutrition issues include seborrhea.

My pancreatitis (Idiopathic Chronic Pancreatitis) is defined primarily by excrutiating pain. Through my research I have discovered a treatment that costs me less than one cent a day and has kept the pancreatic pain away for over 4 years (as of summer 2016).

This article is mainly about the only area left that eludes my ability to manage or control it. That is Seborrheic Dermatitis (seborrhea, or SD).  I have managed to find several Facebook pages that discuss seborrhea with many of the participants offering treatments that have worked for them and possible triggers.

I am not participating in these pages any further. I'm quite fed up with claims by some of a "cure". Fake users offering specific product by brand and name. One even claimed to be suffering from SD and offering links to a website that he controlled and sold products that he was claiming "helped him with his SD". The products were shoddy cosmetics industry products that would have harmed anyone trying them and would distinctly aggravate the SD condition.

There is no cure for seborrhea (or SD or seborrheic dermatitis). None, no cure, period. You can treat the symptoms, you can make them go away for short or long periods ... there is no cure. You can treat the symptoms to control outbreaks and reduce the possibility of infection(s).

Seborrhea is not caused by poor hygiene. It is not an allergy. And it does not harm the body. 

I've had seborrhea for at least the past 45 years. It started out mainly on my scalp with heavy "dandruff" and redness up to the hair line. I also had a spot of redness and flaking below my nose and above my lip on the right side (in the mustache hair area). My doctor at the time suggested trying out dandruff shampoos starting with the tar based shampoos until I found one that worked. I went through all of those and none were really effective for any length of time. I then switched over to "Selun Blue" which worked for a few months. After it stopped working, I tried a few of the different Head and Shoulders products. Nothing really worked for any length of time, until I discovered Nizoral. I could tell from the moment I tried it the first time that this would work. There was a tell-tale "tingling" that came me a comfort level that the redness would go away – and the flaking. I would use the Nizoral daily until the redness and flaking stayed away for at least a full day and then alternate days between Nizoral and regular soap until the redness and flaking stayed away for at least a full two days. Then I switched to weekly, then monthly, then stopped if I remained redness free for at least one month. Small amounts of flaking weren't an issue. If you have had seborrhea, you'll know what I mean ...

I always could foretell when my seborrhea was coming back. I have one spot on the right side of my scalp, just above my ear, that would build up like a hard scab. When that spot started itching, I knew the redness and heavy flaking wasn't far behind. The recurrence of seborrhea was about once a year for most of those years.

Over the past five years, the recurrence has been more often. I attribute that to my pancreatitis. The symptoms of pancreatitis have been there for most of those 45 years, it's just in the last five years that my pancreas has effectively stopped working. It's called Idiopathic Chronic Pancreatitis, meaning no known cause and irrepairable damage to at least 80% of the pancreas. For the past five years, I have been totally dependent on insulin and prescription digestive enzymes to function. Some of the side effects include steatorrhea (oil discharge through the anus from improperly digested fats and proteins) and seborrhea. Seborrhea, incidentally, is also a discharge of oil through the pores near sebasceous glands.

It's that oil that carries the malassezia fungus to the skin surface that causes the problems. The fungus irritates the skin and that increases sebum (skin cell) production that causes the flaking. 

Before I continue with treatments that work for me, I need to point out that malassezia is referred to as a fungus and as a yeast. While both are correct, I don't like to call it a yeast because of the confusion it creates. There are many people with seborrhea looking for treatments that work. When they read about a "yeast", far too many assume it is the most common yeast they hear about and focus on treatments for that ... 

The most commonly prescribed medication to control the symptoms of seborrhea is a topical corticosteroids. Many of us that suffer from seborrhea are well aware of the complications this class of medicine causes. Thinning skin, stretch marks, easy bruising, localized thin hair growth, and in a few cases (mine included) some puss filled growths. A treatment that can be worse than the symptoms it is intended to treat.

Seborrhea is a nasty disease. Many that suffer with seborrhea become shut-ins embarassed with the heavy flaking, constant scratching and infections the scratching can cause. All are looking for a cure, that one miracle to take this all away.

There is no single cure. There are some effective treatments though. What I am going to discuss below are strategies that have worked for me. I am not a doctor, and certainly not involved in the medical community. I do a fair amount of research – focused on my own health issues, and to find natural treatments that work. 

This is where it gets interesting. One of the symptoms of my pancreatitis that is quite similar to seborrhea is steatorrhea ... not because of the name similarity, but because of the output of "oils". I have found a way to control the output of steatorrhea. My doctor and dietitician had suggested using a bulking agent (bran or psyllilum husks) to absorb the oil. That worked, but also causes some additional problems. I discovered, quite by accident, that an omega-3 supplement would also control the steatorrhea and also remove some of the foul odor as well. There were other benefits to the omega-3 supplement and I've been using that for several years now. If I get any steatorrhea returning, it is usually because I have forgotten to take my omega-3 supplements.

So, to test out if omega-3 would help with seborrhea, I double up on the dosage. And, sure enough, the seborrhea symptoms started to improve. I suspect that worked by reduce the output of the oils.

Next, my research focused on the malassezia fungus. Everyone has it, everyone. There are 14 species of this fungus, and they are opportunistic. That means that if you give them the slightest edge, they seize it and grow rapidly ... causing such issues as heavy flaking with extreme itching. It's not a hygiene issue and it cannot be transmitted to anyone else. Can it be controlled? Destroyed? The Nizoral shampoo helps quite a bit. Nizoral's active ingredient is 2% ketoconazole.

While the shampoo worked quite effectively, it's effect needs to be helped out occasionally. That's where my research took me too ... looking at anti-fungal products that could be used sparingly on occasion. Not just any anti-fungal, but an anti-fungal that would be effective on the malassezia fungus. That's part of my gripe with those promoting products, no research ... they read about malassezia and associate it with a yeast and immediately go looking for a yeast treatment – go ahead, look it up on Google. What you end up with is a bunch of treatments designed for candida. Those would have some effect on malassezia, but not really that great.

I ended up finding references to imidazole and ketaconazole with alternatives as zinc pyrithione, selenium sulfide, and (interestingly) propylene glycol. Propylene glycol is also an ingredient in e-cigarettes that I have just quit using. The second interesting coincidence is that ketaconazole is the main ingredient in Nizoral.

More research leads to quite a few of the "azole" family of anti-fungal products. Since I am searching for self-treatment and low-cost options, I did not return to my doctor or visit a dermatologist for this part of my research. I was focused on finding an OTC solution (OTC = Over The Counter). I found a product that contains 2% miconazole at a local pharmacy. A bit on the expensive side at $18.99 for a 15g tube, but worth trying. A bit of a eureka moment following the first 4 or 5 uses ... between the Nizoral and this miconazole cream, the redness was pretty much gone and the flaking stayed away for at least 24 hours. What was most important was finding that the redness stayed away for all that time too ...

I've now found a source for 2% miconazole. I get six tubes (15g each) for about $2 per tube (including shipping).

One of the more expensive solutions was determining one of the triggers of my seborrhea. We have recently sold the house that we lived in for over 30 years. We raised our family there and it was a difficult move. It wasn't just a house, it was a home. It was "just right" for us in every aspect except size. Since our children moved away, we had at least three times the square footage that we needed. Our new home is the right size, just needing that same personalization that comes with time.

One of those "personalization" issues came up rather quickly. Since moving to this new home, my seborrhea has kicked into high gear. Happening frequently and with a ferocity that I haven't seen before. One of the ways that I managed my seborrhea before was to take a shower or bath. That helped get rid of the scaling and flaking ... and with Nizoral, the seborrhea stayed away for quite some time. At the new house, a shower or bath would cause the seborrhea to flare up immediately. The redness was dramatic – someone in the family remarked that I had a sun-burn. 

In my research, I discovered that chlorinated water is a trigger for dermatitis. We installed a whole-house chlorine filter and that trigger is now gone.

Categories: Health

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